Ven the dose matters: Venetoclax dosing in the frontline treatment of AML.

IF 6.9 2区 医学 Q1 HEMATOLOGY Blood Reviews Pub Date : 2024-08-29 DOI:10.1016/j.blre.2024.101238
Dahniel Sastow, Hannah Levavi, Nicole Wagner, Keith Pratz, Douglas Tremblay
{"title":"Ven the dose matters: Venetoclax dosing in the frontline treatment of AML.","authors":"Dahniel Sastow, Hannah Levavi, Nicole Wagner, Keith Pratz, Douglas Tremblay","doi":"10.1016/j.blre.2024.101238","DOIUrl":null,"url":null,"abstract":"<p><p>Older/unfit adults with AML have worse outcomes and fewer treatment options than their younger/fit counterparts. In vitro studies have found a synergistic effect of hypomethylating agents (HMA) with venetoclax (VEN) on AML cells and since the phase 3 VIALE-A trial demonstrated a survival benefit, HMA + VEN has become the standard of care in the frontline setting for older/unfit adults with AML. Unfortunately, the standard 28-day cycle of VEN is associated with a high degree of myelosuppression leading to treatment delays and dose modifications. Many small retrospective studies have successfully shown comparable outcomes to VIALE-A with reduced dose/duration of VEN. Furthermore, low dose metronomic dosing of HMA + VEN has shown clinical benefit while minimizing myelotoxicity. Future trials are vital to understand the appropriate dose of VEN in combination with HMA, to evaluate HMA + VEN compared to intensive therapy for younger/fit patients, and to explore its utility in the relapsed/refractory setting.</p>","PeriodicalId":56139,"journal":{"name":"Blood Reviews","volume":null,"pages":null},"PeriodicalIF":6.9000,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Blood Reviews","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.blre.2024.101238","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Older/unfit adults with AML have worse outcomes and fewer treatment options than their younger/fit counterparts. In vitro studies have found a synergistic effect of hypomethylating agents (HMA) with venetoclax (VEN) on AML cells and since the phase 3 VIALE-A trial demonstrated a survival benefit, HMA + VEN has become the standard of care in the frontline setting for older/unfit adults with AML. Unfortunately, the standard 28-day cycle of VEN is associated with a high degree of myelosuppression leading to treatment delays and dose modifications. Many small retrospective studies have successfully shown comparable outcomes to VIALE-A with reduced dose/duration of VEN. Furthermore, low dose metronomic dosing of HMA + VEN has shown clinical benefit while minimizing myelotoxicity. Future trials are vital to understand the appropriate dose of VEN in combination with HMA, to evaluate HMA + VEN compared to intensive therapy for younger/fit patients, and to explore its utility in the relapsed/refractory setting.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Ven 剂量很重要:急性髓细胞白血病一线治疗中的 Venetoclax 剂量。
与年轻/身体健康的患者相比,老年/身体不健康的成人急性髓细胞白血病患者的治疗效果更差,治疗方案更少。体外研究发现,低甲基化药物(HMA)与 Venetoclax(VEN)对急性髓细胞白血病细胞有协同作用,自从 VIALE-A 3 期试验显示生存获益后,HMA + VEN 已成为急性髓细胞白血病老年/非适应症成人患者的一线治疗标准。遗憾的是,标准的 28 天 VEN 周期与高度骨髓抑制有关,导致治疗延迟和剂量调整。许多小型回顾性研究成功表明,在减少 VEN 剂量/疗程的情况下,疗效与 VIALE-A 相当。此外,HMA + VEN 的低剂量节律给药已显示出临床疗效,同时将骨髓毒性降至最低。未来的试验对于了解 VEN 与 HMA 联用的适当剂量、评估 HMA + VEN 与针对年轻/适合患者的强化治疗的比较以及探索其在复发/难治性病例中的应用至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Blood Reviews
Blood Reviews 医学-血液学
CiteScore
13.80
自引率
1.40%
发文量
78
期刊介绍: Blood Reviews, a highly regarded international journal, serves as a vital information hub, offering comprehensive evaluations of clinical practices and research insights from esteemed experts. Specially commissioned, peer-reviewed articles authored by leading researchers and practitioners ensure extensive global coverage across all sub-specialties of hematology.
期刊最新文献
From MGUS to multiple myeloma: Unraveling the unknown of precursor states. Advancing CAR T-cell therapies: Preclinical insights and clinical translation for hematological malignancies. Corrigendum to "Measurable residual disease (MRD)-testing in haematological cancers: A giant leap forward or sideways?"[BLOOD REVIEWS, 9 August 2024, https://doi.org/10.1016/j.blre.2024.101226]. Clinical applications of circulating tumor DNA in hematological malignancies: From past to the future Tailoring oral anticoagulant treatment in the era of multi-drug therapies for PAH and CTEPH.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1